{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,17]],"date-time":"2025-10-17T00:17:20Z","timestamp":1760660240017,"version":"build-2065373602"},"reference-count":15,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T00:00:00Z","timestamp":1756857600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Sex Transm Infect"],"accepted":{"date-parts":[[2025,7,7]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In 2018, Rwanda incorporated oral pre-exposure prophylaxis (PrEP) with tenofovir and emtricitabine (Truvada) into national HIV guidelines as part of a comprehensive HIV prevention programme for female sex workers (FSWs). This study assessed the impact of PrEP on HIV incidence among FSWs in urban Rwanda.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted a retrospective cohort study among HIV-negative FSWs aged\u226518 years at 20 health facilities in Kigali from January 2019 to October 2021. All participants received standard HIV prevention services including routine condom distribution, peer education activities and the option to receive daily oral PrEP. Those who consented to receive PrEP formed the exposed group and those who declined or were not eligible to receive PrEP formed the control group. We used Cox regression to assess HIV seroconversion and logistic regression to assess retention in care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 1897 FSWs (median age 30.1 years, IQR: 25.2\u201335.6), 1129 (59.5%) initiated PrEP. The HIV incidence rate was 0.40 per 100 person-years (PYs) among FSWs in the PrEP group versus 1.83 per 100 PYs for those in the non-PrEP group. In multivariate analysis, PrEP was associated with a reduced risk of HIV seroconversion (adjusted HR: 0.25; 95%\u2009CI: 0.09 to 0.71). Retention in the HIV prevention programme at 12 months was 77.6% among FSW who used PrEP versus 73.6% among non-users (adjusted OR: 1.29 (95% CI: 1.03 to 1.60).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Oral PrEP was associated with reduced HIV risk of HIV seroconversion among FSWs in Kigali. However, the small number of HIV seroconversions and limitations of the observational design warrant cautious interpretation of study findings.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/sextrans-2024-056189","type":"journal-article","created":{"date-parts":[[2025,9,3]],"date-time":"2025-09-03T17:20:37Z","timestamp":1756920037000},"page":"475-478","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness of the national HIV pre-exposure prophylaxis (PrEP) programme among female sex workers in Rwanda: a retrospective cohort study"],"prefix":"10.1136","volume":"101","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-8877","authenticated-orcid":false,"given":"Eric","family":"Remera","sequence":"first","affiliation":[{"name":"Swiss Tropical and Public Health Institute, University of Basel Faculty of Medicine, Basel, BS, Switzerland"},{"name":"Research Innovations and Data Science, Rwanda Biomedical Center, Kigali, Kigali City, Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sabin","family":"Nsanzimana","sequence":"additional","affiliation":[{"name":"Republic of Rwanda Ministry of Health, Kigali, Rwanda"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fr\u00e9d\u00e9rique","family":"Chammartin","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology and Biostatistics, Department of Clinical Research, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiner C","family":"Bucher","sequence":"additional","affiliation":[{"name":"Division of Clinical Epidemiology, University Hospital Basel and University of Basel, Department of Clinical Research, University Hospital Basel, Basel, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,9,3]]},"reference":[{"key":"2025101602151350000_101.7.475.1","doi-asserted-by":"publisher","DOI":"10.1097\/00002030-199301000-00015"},{"key":"2025101602151350000_101.7.475.2","doi-asserted-by":"crossref","first-page":"e1244","DOI":"10.1016\/S2214-109X(24)00227-4","article-title":"HIV incidence among women engaging in sex work in sub-Saharan Africa: a systematic review and meta-analysis","volume":"12","author":"Jones","year":"2024","journal-title":"Lancet Glob Health"},{"key":"2025101602151350000_101.7.475.3","doi-asserted-by":"crossref","DOI":"10.2196\/50743","article-title":"Estimation of the Population Size of Street- and Venue-Based Female Sex Workers and Sexually Exploited Minors in Rwanda in 2022: 3-Source Capture-Recapture","volume":"10","author":"Tuyishime","year":"2024","journal-title":"JMIR Public Health Surveill"},{"key":"2025101602151350000_101.7.475.4","unstructured":"Rwanda Biomedical Centre . Behavior and biological survey among female sex workers . 2023."},{"key":"2025101602151350000_101.7.475.5","doi-asserted-by":"crossref","first-page":"108","DOI":"10.15171\/ijhpm.2019.91","article-title":"HIV Modes of Transmission in Sudan in 2014","volume":"9","author":"Nasirian","year":"2019","journal-title":"Int J Health Policy Manag"},{"key":"2025101602151350000_101.7.475.6","doi-asserted-by":"publisher","DOI":"10.1097\/QAD.0000000000001145"},{"key":"2025101602151350000_101.7.475.7","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1003492","article-title":"HIV incidence after pre-exposure prophylaxis initiation among women and men at elevated HIV risk: A population-based study in rural Kenya and Uganda","volume":"18","author":"Koss","year":"2021","journal-title":"PLoS Med"},{"key":"2025101602151350000_101.7.475.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pgph.0002524","article-title":"Factors associated with retention on pre-exposure prophylaxis among female sex workers in Kigali, Rwanda","volume":"3","author":"Mubezi","year":"2023","journal-title":"PLOS Glob Public Health"},{"key":"2025101602151350000_101.7.475.9","unstructured":"World Health Organization (WHO) . Guideline on when to start antiretroviral therapy and on pre-exposure prophylaxis for hiv. 2015 Available: https:\/\/iris.who.int\/bitstream\/handle\/10665\/186275\/9789241509565_eng.pdf"},{"key":"2025101602151350000_101.7.475.10","doi-asserted-by":"crossref","first-page":"e219","DOI":"10.1016\/S2352-3018(20)30003-5","article-title":"Lessons on PrEP from the SEARCH study in east Africa","volume":"7","author":"Celum","year":"2020","journal-title":"Lancet HIV"},{"key":"2025101602151350000_101.7.475.11","doi-asserted-by":"crossref","DOI":"10.1136\/bmjgh-2020-002300","article-title":"Prevalence and incidence of HIV among female sex workers and their clients: modelling the potential effects of intervention in Rwanda","volume":"5","author":"Nsanzimana","year":"2020","journal-title":"BMJ Glob Health"},{"key":"2025101602151350000_101.7.475.12","unstructured":"R Core Team . R: a language and environment for statistical computing. r foundation for statistical computing. 2021 Available: https:\/\/www.R-project.org\/"},{"key":"2025101602151350000_101.7.475.13","doi-asserted-by":"crossref","DOI":"10.3389\/frph.2024.1332236","article-title":"HIV seroconversion among female sex workers: retrospective cohort study from a large-scale HIV prevention and sexual and reproductive health program in Tanzania","volume":"6","author":"Mbita","year":"2024","journal-title":"Front Reprod Health"},{"key":"2025101602151350000_101.7.475.14","doi-asserted-by":"crossref","first-page":"S569","DOI":"10.1093\/infdis\/jiu493","article-title":"The price of sex: condom use and the determinants of the price of sex among female sex workers in eastern Zimbabwe","volume":"210 Suppl 2","author":"Elmes","year":"2014","journal-title":"J Infect Dis"},{"key":"2025101602151350000_101.7.475.15","doi-asserted-by":"crossref","first-page":"486","DOI":"10.1002\/phar.2240","article-title":"Review of Real-World Implementation Data on Emtricitabine-Tenofovir Disoproxil Fumarate as HIV Pre-exposure Prophylaxis in the United States","volume":"39","author":"Adams","year":"2019","journal-title":"Pharmacotherapy"}],"container-title":["Sexually Transmitted Infections"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/sextrans-2024-056189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,16]],"date-time":"2025-10-16T09:15:27Z","timestamp":1760606127000},"score":1,"resource":{"primary":{"URL":"https:\/\/sti.bmj.com\/lookup\/doi\/10.1136\/sextrans-2024-056189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,3]]},"references-count":15,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2025,10,16]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/sextrans-2024-056189"],"URL":"https:\/\/doi.org\/10.1136\/sextrans-2024-056189","relation":{},"ISSN":["1368-4973","1472-3263"],"issn-type":[{"type":"print","value":"1368-4973"},{"type":"electronic","value":"1472-3263"}],"subject":[],"published":{"date-parts":[[2025,9,3]]}}}